What is Chemotherapy?

The last thing I want to do is scare anybody facing Chemotherapy, but I know when I was facing it I was nervous about what was ahead.

Now here's the first thing to remember.  Chemotherapy, or Chemo as it's often called, will be different for everybody.  Give two people the same toxic mix and you'll get different reactions, so what follows is my experience (with a couple of other bits thrown in) which I'm sharing in the hope that it will help anyone reading this that might be about to go through the same.

Before you begin chemotherapy you will be made an appointment on the Chemotherapy ward at the hospital, along with other patients who will be starting treatment at the same time.  Here you are all, men and women, taken into a dark soulless meeting room where a head nurse will talk you through a slide show of how chemotherapy is administered and it's possible side effects - sickness, fatigue -  and we are are told that we will lose our hair.

We are also advised against the dangers of going out among the public.  Our immune systems will be battered leaving us susceptible to catching any rotten thing going. Basically if having cancer isn't depressing enough, it wants to take away any chance of you enjoying yourself too.

Prior to your treatment you will need a blood test.  This is usually around 48 hours before.  They will check the cancer markers, cell count and liver and kidney function.  At the beginning it is to so they can check that the treatment is working to compare results, as you progress, not only will they check that the chemotherapy is having the effect it should, but they will also check if there is any damage to your liver and kidneys from the treatment. 

If you are older you might expect to have an ECG prior to beginning treatment.  This is to check that your heart is able to cope with the effects of chemotherapy. At my age it was assumed that it was OK, though my heart would be checked in the usual way, with a stethoscope at every follow up appointment.  At the same time they will be check that your lungs are clear. 

Chemotherapy clinic never runs on time, so be prepared to hang around.  This is normally due to the pharmacy releasing the medicines and sometimes how quickly they are able to administer the medicines to you. 

Your first treatment will hopefully be the  longest you have to experience.  If there are no adverse effects during this then they will aim to speed up the rate at which they pump it into your body the next time.  They will do it as fast as your body can take it and as quickly as a nurse is available to administer it. 

Delays such as these all have a knock on effect throughout the day, so allow plenty of time.  Take a book, phone, IPad.  Whatever you need to pass the time and take your mind off what's going on. You are allowed to take someone with you, so if someone is available take them, unless of course you're happier on your own (just don't take that friend with a phobia of needles though)

OK, onto the nitty gritty.  Your chemotherapy is administered on a ward.  There are several bays and whereas on a normal hospital ward there is a bed, on a chemotherapy ward there are six of those big old chairs you see in old folks homes.  Once seated, your arm is rested onto a pillow and a cannula inserted into the back of your hand. 

Top tip - make sure your hands are warm.  I ended up taking a hot water bottle with me because if your veins are cold it's harder for them to find a vein and they'll jab away for ages, sometimes swapping nurses, if one can't find a vein, another will try. They have to ensure it is fully in as if the chemotherapy leaks it can burn the flesh around it.  The longer you have chemo, the harder it is to find a good vein as they become weakened.  If, like me, you've had lymph nodes removed in your arm pit to check for the spread of the disease (sentinel biopsy) , you will always have to use the opposite arm.  This I'm told will always be the case for me with any injections or blood tests in the future, unless it is absolutely necessary to use the other arm.

You will wait for your particular mix of chemotherapy to be released from the pharmacy.  There are lots of different types of chemotherapy drugs and yours will be tailored to your specific cancer. Mine was F.E.C. Three different chemotherapy drugs. First your line is flushed and two nurses will double check the drugs with your consultants prescription before administering the first  - it may be via a drip or via an injection into your cannula.

On your first round, a chemotherapy a nurse will stay with you throughout to monitor for any side effects. On your following visits you will share your nurse with others on your bay. A chair on wheels helps them scoot from one patient to the next.

The first two parts of my chemotherapy mixture were usually fine with me, occasionally if they'd put it in a small vein you could feel the pulse of the liquid medication pumping in, which could be unpleasant and occasionally painful. The worst one for me was the C drug.  They would give me ice pops to suck on as they administered it as it could make your mouth burn.  This one made me feel sick.  I was never actually physically sick but I'd feel really nauseous.  The thought of an ice pop now turns my stomach, even just typing this.  When my Mum had chemotherapy they used to come round with packaged sandwiches. now the sight of one or the sound of a tea trolley makes her feel the same.

Once your session is over, you will be made an appointment with your consultant.  I had chemo every three weeks, so, as I mentioned before, your appointment would be around 48 hours before your next treatment when you see your consultant, well that's the idea, often it would be a registrar so there was little continuity. If whoever you see deems you well enough, you are then sent for your blood test.  All being well, the time in between chemo sessions would allow you to recover.  If you haven't and your cell count isn't right, you may get your next session postponed.  I had it at least twice where my cells had not recovered and I would receive a phone call to tell me. 

If this was the case you would have another blood test on the day and hope that in those 48 hours you had recovered enough to have your treatment.  Eating raw garlic was recommended to help the blood cells recover. Thankfully I never had to postpone a session.

Around the second round of chemo you begin to lose your hair.  You may be offered a cold cap. A device which freezes the top of your head which in theory protects the hair cells thus preventing the hair falling out.  I heard mixed opinions on this.  One was that if there was any stray cancer cells lurking up there then you could be preventing them from being killed.   I didn't want to take that chance, to go through all this for it not to work, plus I heard that your hair would still be patchy anyway, so I gave it a miss.

I would be fine after each session, then bang - two or three days later it would hit.  I'd wake up hardly able to lift my head off the pillow I was so weak.  I would make an effort to get up but it would feel like a dark heavy weight was pushing me down and again I would give into sleep.  This would last around 4 days. I was warned about it, but I never thought it would affect me the way it did.  I thank God for my Mum coming round as there were days when I was too weak to even get myself a drink. The fatigue eventually passes, then, just as you're returning to normal, it's time for that next blood test to see if you're well enough to take it again. Some people suffer sickness, thankfully I didn't, but you are prescribed steroids and anti-sickness medication to take between treatments.

You will count down each session as another under your belt. At your final session you will have a mixture of emotions such as 'Thank God' and 'What now?' There are no gongs or fanfares when that final cannula is removed (well there wasn't at my hospital anyway), you simply get up and go home.  I'm sure some people celebrate, like some I felt like it was tempting fate to celebrate, so had a quiet drink.  

It seems an odd ending, but as they told me, everybody's journey is their own.  I hope one day soon they find a quicker, easier cure, or better still, a prevention. Either way, be strong on your own journey.  

You will get through it.

Love T x